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Objective To investigate the clinical application and efficacy of DNA immune absorption in patients with lupus interstitial pneumonia.Methods to collect randomized 18 patients with lupus patients with pneumonia were enrolled in the study and randomly divided into immunoadsorption group and traditional CTX treatment group,in order to observe the ESR,CRP,ANA quantitative monitoring at different time,pulmonary function test (diffusing capacity of the lung for carbon monoxide,DLCO),6 min walking distance,procalcitonin (PCT).The difference between groups was statistically analyzed and the effect of DNA immunization was discussed.Results There were significant differences between immunoadsorption group and control group in ESR at the different time points before and after the treatment (Fgroup =7.841,P＜0.05;Fcross =6.512,P ＜0.05;Finteraction =10.421,P＜0.05),CRP(Fgroup =6.995,P＜0.05;Fcross=5.847,P＜0.05;Finteraction =8.847,P＜ 0.05) and ANA quantitative monitoring (FgrouP =12.336,P ＜ 0.05;Fcross =11.214,P ＜ 0.05;Finteraction =15.847,P＜0.05).At 1 and 2 weeks after treatment,CRP and ESR of the immunoadsorption group began to decrease,and the difference was statistically significant compared with those before treatment (P ＜0.05),while the difference between the control group and the treatment group was statistically significant after 4 weeks (P＜0.05).After 2 weeks of treatment,there was a significant difference in ANA quantitative monitoring between the immunoadsorption group,compared with that before treatment.There was a significant difference between the control group before treatment and the 6 months after treatment (P＜0.05).There was a significant difference between the immunoadsorption group and the control group in pulmonary function test (FgrouP =6.222,P＜ 0.05:Fcross =7.154,P＜ 0.05:Finteraction =8.527,P ＜ 0.05),6 min walking distance (FgrouP =8.669,P＜ 0.05;Fcross =7.154,P ＜ 0.05;Finteraction =11.547,P＜ 0.05) and PCT (FgrouP =5.621,P ＜0.05;Fcross =4.125,P ＜ 0.05;Finteraction =7.554,P ＜ 0.05.The pulmonary function and 6 min walking distance of 2-week treatment in the immunoadsorption group.There showed a significant difference compared with that before treatment.The difference between the control group after 4 weeks of treatment and that before treatment was statistically significant (P=＜0.05).There was a significant difference between the 2 weeks PCT treatment in the immunoadsorption group and that before treatment (P＜0.05).There was a significant difference between the control group after 3 months of treatment and before treatment (P ＜ 0.05).Conclusion The treatment of lupus interstitial pneumonia in traditional regimens is ineffective,and the efficacy of DNA is better than that of conventional regimens,and reduces the risk of infection.
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Objective To observe the PML protein expression of hepatocellar carcinoma tissue and cells lines and As 2 O3 regulate its expression .Methods Immunohistochemistry was used to examine the PML protein expression of hepatocellar carcinoma tissue . Western blot analysis were used to observe PML protein expression of hepatocellar carcinoma tissue of 12 cases ,5 hepatocellar car-cinoma cell lines ,such as HuH7 ,HepG2 ,Hep3B ,SMMC-7721 ,MHC97H .Western blot analysis was used to detected the PML pro-tein expression of these hepatocellar carcinoma cell lines after 72-96 h treated with 0 .25 μg/mL of As2 O3 .Results Immunohisch-enmical staining showed that the PML protein was expressed in both cytoplasm and nucleus ,did not well-distributed in hepatocellar carcinoma cells .There was no significant differences of PML protein expressed among differently differentiated stages of hepatocel-lar carcinoma cells .Western blot analysis found that hepatocellar carcinoma tissues of 12 cases with hepatocellar carcinoma ex-pressed PML protein ,and there was significant difference of PML protein expressed among 12 cases suffer with hepatocellar carci-noma .hepatocellar carcinoma cell lines ,such as HuH7 ,HepG2 ,Hep3B ,SMMC-7721 and MHC97H all expressed PML protein ,and there was little difference of PML protein expressed among hepatocellar carcinoma cell lines .The PML protein expression of HuH7 ,HepG2 ,Hep3B ,SMMC-7721 and MHC97H cell after 72-96 h treated with 0 .25 μg/mL of As2O3 significant decreased . Conclusion Hepatocellar carcinoma tissue and cells may express PML protein ,and As2 O3 may regulate this protein expression as well .PML protein may be the target molecule of As2 O3 treating HCC .
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Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.
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Objective To compare the clinical effects of remifentanil combined with sevoflurane or with isoflurane in elderly patients undergoing radical gastrectomy for cancer and their recovery.Methods Sixty-two patients,who scheduled for radical gastrectomy for cancer was randomly divided into remifentanil combined with sevoflurane group ( SR group,n =31 ) and remifentanil combined with isoflurane group ( IR group,n =31 ).They were classified into American Society of Anesthesiology(ASA) physical status Ⅱ and ,The procedure of two Anesthesia was same,in which remifentanil was continually pumped into at the same velocity using micro pump immediately after intubation,tili the target density in plasma increased to 6 μg/L.Sevoflurane at 1.5％ to 2.0％ was inhaled in the SR group,whereas isoflurane at 1％ to 2％ in the IR group.The inhalation was ended at 5 mins before the surgery was completed,Remifentanil was stopped while stuturing,and 0.1 mg of Remifentanil was injected at 20 mins before the surgery was completed.The heart rate(HR) and blood pressure were recorded at before induction of anesthesia (T0),after induction of anesthesia ( T1 ),immediate intubation ( T2 ),surgery after the start of 5 min ( T3 ),30 min (T4) and the time of surgery ( T5 ),respectively.The recovery time and extubation time,and quality score for awakening after extubation (OAAS) were also recorded.Results There were no significant differences in HR,SBP and DBP at every time points observed between the two groups.The recovery time( 10.4 ± 3.9)mins and extubation time(5.9 ± 3.1 )min in SR group was significantly shorter than that of(16.3 ± 5.8) min and (9.7 ±2.5) min in the IR group(t =6.25 and 4.19,P =0.02 and 0.01,respectively ).The OAAS after extubation in the two groups gradually increased,and immediately after extubation and extubation after 10 min,OAAS in the SR group was(4.1 ± 1.2),which was significantly higher than that of (2.9±1.0)in the IR group(t =3.27,P =0.03).Conclusion Either stevoflurane-remifentanil or isoflurane remifentanil anesthesia can be used safely in elderly patients undergoing radical gastrectomy for cancer.Anesthesia with Sevoflurane-remifentanil provides better faster recovery than isoflurane- remifentanil in elderly patients.